Tuberculosis, Infertility May Have Influenced George Orwell's Writing

George Orwell, born in India in 1903 as Eric Blair, was a sickly child, suffering multiple bouts of bronchitis and other respiratory ailments. As a young man, he had several episodes of bacterial pneumonia, and also contracted dengue fever during his time in Burma. A heavy smoking habit probably also contributed to his gaunt appearance. Perhaps due to his childhood respiratory illnesses, Orwell developed bronchiectasis, a condition characterized by perpetually dilated bronchi and fits of coughing.

In 1938, Orwell went to a sanatorium because he was coughing up blood, and was eventually diagnosed with tuberculosis. The peripatetic author could have been infected in his childhood in India, as a police officer in Burma, as a soldier in Spain, or “during…years of tramping, poverty, and vagabondage” in France and England, according to author John Ross, MD, of Caritas St. Elizabeth’s Medical Center in Boston. His treatment consisted of simple bed rest and good nutrition--both of which improved his health enough for him to be discharged several months later.

Eight years later, depressed by his wife’s death, Orwell moved to a windy and damp Scottish island. His health worsened significantly just as he was working on the first draft of 1984. Fever, weight loss, and night sweats sent him to the hospital, where he underwent “collapse therapy,” a treatment designed to close the dangerous cavities that form in the chests of tuberculosis patients. Orwell described his experience with collapse therapy in detail, and the treatment “may have influenced the depiction of the tortures of Winston Smith in the Ministry of Love” in 1984, according to Dr. Ross. “But the truly frightening thing was the emaciation of his body. The barrel of the ribs was as narrow as that of a skeleton: the legs had shrunk so that the knees were thicker than the thighs…the curvature of the spine was astonishing,” Orwell wrote, perhaps drawing on his firsthand knowledge of the wasting effects of tuberculosis.

Orwell’s poor health and apparent infertility (based on his own musings in his letters as well as the medical evidence linking some respiratory ailments to infertility) probably contributed to the despondency in his writing. “Orwell himself told his friends that 1984 would have been less gloomy had he not been so ill—it was a very dark, disturbing, and pessimistic work,” Dr. Ross said. The author’s severe illness “gave him a tremendous amount of focus,” perhaps by making him aware of his own mortality.

George Orwell died in 1950, ending a life plagued by sickness. That sickness, though, contends Dr. Ross, “made him a better and more empathetic writer, in that his sense of human suffering made his writing more universal.”

###

Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty. It is published under the auspices of the Infectious Diseases Society of America (IDSA). Based in Alexandria, Virginia, IDSA is a professional society representing about 8,000 physicians and scientists who specialize in infectious diseases. For more information, visit www.idsociety.org.